title: Three-level en bloc spondylectomy for chordoma.
abstract: BACKGROUND
  En bloc resection of spinal and sacral chordomas may convey a survival benefit. However, these procedures often are complex and require the surgeon to plan a procedure that results in negative tumor margins, protects vital neurovascular structures, and concludes with a viable biomechanical reconstruction.
  
  
  OBJECTIVE
  We present a case of a 3-level en bloc lumbar spondylectomy and reconstruction.
  
  
  METHODS
  A case of a 45-year-old woman with biopsy-proven exophytic L4 chordoma is presented. The patient underwent successful L3-L5 en bloc spondylectomy and reconstruction over 3 stages.
  
  
  RESULTS
  The patient did well following the procedure, and was neurologically intact at 6-week follow-up.
  
  
  CONCLUSIONS
  Three-level en bloc spondylectomy with lumbopelvic reconstruction is a challenging yet feasible procedure.
authors.affiliation: Department of Neurosurgery, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Clarke
authors.forename: Wesley
authors.initials: W
authors.lastname: Hsu
authors.forename: Ian
authors.initials: I
authors.lastname: Suk
authors.forename: Edward
authors.initials: E
authors.lastname: McCarthy
authors.forename: James H
authors.initials: JH
authors.lastname: Black
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Sciubba
authors.forename: Ali
authors.initials: A
authors.lastname: Bydon
authors.forename: Reza
authors.initials: R
authors.lastname: Yassari
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Witham
authors.forename: Ziya L
authors.initials: ZL
authors.lastname: Gokaslan
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Wolinsky
mesh_terms: D001706:Biopsy; D002817:Chordoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012447:Sacrum / Q000473:pathology / Q000601:surgery*; D013125:Spinal Neoplasms / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome